Cesarean delivery rates by hospital type among nulliparous and multiparous patients

Ghafari-Saravi, Afsoon; Chaiken, Sarina R.; Packer, Claire H.; Davitt, Caroline C.; Garg, Bharti; Caughey, Aaron B.

doi:10.1080/14767058.2021.1990884

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…The reason for this difference is unknown as the dataset contains scant facility-related birth data. However, our results add to a body of research showing factors independent of a woman's and her fetus’ health (i.e., birth facility) can affect birth mode (Ghafari-Saravi et al, 2021; Janevic et al, 2020; Triebwasser et al, 2019). Reasons for systematic disparity in birth outcomes by facility are numerous, multifactorial, and beyond the scope of this study.…”

Section: Discussionsupporting

confidence: 59%

“…Moreover, adjusting for hospital and patient characteristics (e.g., age, insurance, parity, and health conditions), non-Hispanic Black, Asian, and Hispanic women are significantly more likely to have a primary (first) cesarean birth than non-Hispanic White women (Okwandu et al, 2022), which is the strongest predictor of future cesarean birth (Martin et al, 2021). Disparities in cesarean birth prevalence have been linked to healthcare provider, facility, and ethnic composition of a woman's neighborhood, with majority Hispanic neighborhoods having higher rates of cesarean birth (Carlson et al, 2018; Ghafari-Saravi et al, 2021; McDonald et al, 2020; Souter et al, 2019). These findings suggest that systemic inequities, combined with individual risk factors that remain poorly understood, shape birth outcomes among this important, underserved population (Howland et al, 2019; Janevic et al, 2020).…”

Section: Purposementioning

confidence: 99%

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Acculturation, Acculturative Stress, Experience of Discrimination, and Cesarean Birth in Mexican American Women

Spurlock

Pickler

Ruiz

et al. 2023

Hisp Health Care Int

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Introduction: There is evidence that Mexican Americans are more likely to have cesarean birth than non-Hispanic White Americans. The purpose of this study was to identify factors related to acculturation along with psychological and sociodemographic factors associated with birth mode in a prospective cohort of Mexican American women in Texas. Methods: This secondary analysis included 244 Mexican American pregnant women. Women with a prior cesarean birth were excluded. Variable selection was guided by Berry's Theoretical Framework of Acculturation. Correlations and logistic regression were used to examine relationships and predict risk of cesarean birth. Mediators and moderators were also considered. Results: Eighty women birthed by cesarean. Analytic and parent samples were similar in all demographics. After controlling for parity in logistic regression, greater Spanish language-related acculturative stress (adjusted odds ratio [AOR], 1.06, 95% confidence interval [CI] [1.01, 1.11], p = .028) and experience of discrimination (AOR, 1.18, 95% CI [1.00, 1.38], p = .044) increased the odds of cesarean birth. The relationship between acculturative stress and birth mode was moderated by birth facility. Conclusion: Acculturative stress and discrimination may play a role in birth mode for Mexican American women birthing in Texas. Birth facility and acculturative stress may be interacting in ways that have clinical significance but are yet unexplored.

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Section: Discussionsupporting

confidence: 59%

Section: Purposementioning

confidence: 99%

Acculturation, Acculturative Stress, Experience of Discrimination, and Cesarean Birth in Mexican American Women

Spurlock

Pickler

Ruiz

et al. 2023

Hisp Health Care Int

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“…We used these categories because teenagers (<20 years old) and advanced maternal age (≥35 years) are at an increased risk for adverse perinatal outcomes. 40,41 On the basis of the previous literature, 42 we have categorized prenatal visits into less than 5 or at least 5 total prenatal visits. Patients were identified as either nulliparous or multiparous.…”

Section: Methodsmentioning

confidence: 99%

Impact of Prenatal Cannabis Use Disorder on Perinatal Outcomes

et al. 2022

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ObjectivesWith legislative changes to cannabis legalization and increasing prevalence of use, cannabis is the most commonly used federally illicit drug in pregnancy. Our study aims to assess the perinatal outcomes associated with prenatal cannabis use disorder.MethodsWe conducted a retrospective cohort study using California linked hospital discharge-vital statistics data and included singleton, nonanomalous births occurring between 23 and 42 weeks of gestational age. χ2 Test and multivariable logistic regression were used for statistical analyses.ResultsA total of 2,380,446 patients were included, and 9144 (0.38%) were identified as using cannabis during pregnancy. There was a significantly increased risk for adverse birthing person outcomes, including gestational hypertension (adjusted odds ratio [AOR], 1.19; 95% confidence interval [CI], 1.06–1.34; P = 0.004), preeclampsia (AOR, 1.16; 95% CI, 1.0–1.28; P = 0.006), preterm delivery (AOR, 1.45; 95% CI, 1.35–1.55; P < 0.001), and severe maternal morbidity (AOR, 1.22; 95% CI, 1.02–1.47; P = 0.033). Prenatal cannabis use disorder was also associated with an increased risk of neonatal outcomes including respiratory distress syndrome (AOR, 1.16; 95% CI, 1.07–1.27; P < 0.001), small for gestational age (AOR, 1.47; 95% CI, 1.38–1.56; P < 0.001), neonatal intensive care unit admission (AOR, 1.24; 95% CI, 1.16–1.33; P < 0.001), and infant death (AOR, 1.86; 95% CI, 1.44–2.41; P < 0.001). There was no statistically significant difference in stillbirth (AOR, 0.96; 95% CI, 0.69–1.34; P = 0.80) and hypoglycemia (AOR, 1.22; 95% CI, 1.00–1.49; P = 0.045)ConclusionsOur study suggests that prenatal cannabis use disorder is associated with increased maternal and neonatal morbidity and mortality. As cannabis use disorder in pregnancy is becoming more prevalent, our findings can help guide preconception and prenatal counseling.

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“…Hospital characteristics also have an effect [13]. Previous studies have shown that hospital ownership [14], equipment levels [15], teaching status [16], and hospital size all have an impact on the use of caesareans [17].…”

Section: Introductionmentioning

confidence: 99%

Staff Resources in Public and Private Hospitals and Their Implication for Medical Practice: A French Study of Caesareans

Zbiri,

Rozenberg,

Milcent

2024

Healthcare

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This study aimed to investigate the effect of hospital staffing resources on medical practice in public versus private hospitals. We used exhaustive delivery data from a French district of 11 hospitals over an 11-year period, from 2008 to 2018, including 168,120 observations. We performed multilevel logistic regression models with hospital fixed or random effects, while controlling for factors known to influence obstetric practice. We found that hospital staff ratios of obstetricians and that of midwives affected caesarean rates, but with different effects depending on the hospital sector. In public hospitals, the higher the ratio of obstetricians and that of midwives, the lower the probability of planned caesareans. In private hospitals, the higher the ratio of obstetricians, the greater the probability of planned caesareans. Indeed, in public hospitals, obstetricians and midwives, both salaried employees, do not have financial or organizational incentives to perform more caesareans. In private hospitals, obstetricians, who are independent doctors, may have such incentives. Our results underline the importance of having an adequate supply of health professionals in healthcare facilities to ensure appropriate care, with specific regard to the different characteristics of the public and private sectors.

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Cesarean delivery rates by hospital type among nulliparous and multiparous patients

Cited by 5 publications

References 23 publications

Acculturation, Acculturative Stress, Experience of Discrimination, and Cesarean Birth in Mexican American Women

Acculturation, Acculturative Stress, Experience of Discrimination, and Cesarean Birth in Mexican American Women

Impact of Prenatal Cannabis Use Disorder on Perinatal Outcomes

Staff Resources in Public and Private Hospitals and Their Implication for Medical Practice: A French Study of Caesareans

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